Abstracts Health Sciences

Improving physical activity for health among inactive adults aged 50 years and older: development, design and delivery of a community-based intervention

by ANDREW O'REGAN

As adults get older, they acquire more chronic health conditions, but engage in less physical activity. Most older adults do not meet the minimum physical activity guidelines for health. Community-based interventions can address this, but evidence is needed to understand how they work, and for associations between accelerometer-measured physical activity and chronic health conditions and healthcare utilisation. The objectives of this thesis are to: inform the recruitment to, and development of an intervention to increase physical activity in adults aged 50 years and older – Move for Life; to design a protocol to test the feasibility of the intervention; to investigate feasibility measures; and to test the hypothesis that physical activity is related to chronic health conditions and healthcare use. Methods Paper 1 was a qualitative study, involving semi-structured interviews (n=18) and four focus groups (n=29) with older adults, advocates and professionals; data were analysed thematically. The purpose of paper 1 was to inform the intervention development and, specifically, to optimise intervention recruitment, sustainability and scalability. Paper 2 outlined a protocol for a three-arm cluster pilot randomised controlled trial. The setting was eight Local Sports Partnership (LSP) hubs; each hub was a unit of randomisation (cluster), and individuals were the units of analysis (participants). The hubs were randomised: true control, usual programme or Move for Life intervention. The true control group was given information about physical activity but was not included in a programme; the intervention arm involved augmentation of existing physical activity classes with the Move for Life intervention; and usual care groups had physical activity classes delivered as normal. The recruitment target was 576 participants. Data were collected at baseline (T0), upon completion of programmes (T1) and at three-month follow-up (T2). Data collected included: demographic data, information on chronic health conditions, healthcare utilisation data, objective physical parameters, e.g., body mass index and grip strength. All participants were asked to wear a device on the thigh for measuring physical activity and sedentary behaviour (activPAL). The third paper used baseline data generated from a sample of adults recruited to the trial, that provided valid activPAL data (n=485). Hierarchical cluster analysis was conducted using the accelerometer-measured physical activity variables. Descriptive statistics were used to investigate associations with chronic conditions and healthcare utilisation. Paper 4 provides a description of the intervention development, using the intervention mapping protocol. The process of intervention development involved: input from key stakeholders, evidence from the published literature, behavioural change theory, and the experience of an interdisciplinary team, who understood the context and environment of the setting. Results Paper 1 reported on factors for successful…